Nursing Care Hub with AHS

dayandnight · Feb 19, 2016

If I may add something, I have heard of the system in Alberta and it sounds awesome. I am an RN in BC. We as a LPN and RN team take 10-11 patients total in our medical wing, and we only have 1 care aid for the entire floor. Often times 1 care aid for 30 patients while they also work as porters until 3 pm. After that we have no help until the morning. Rns and LPNs admit their own patients from the ICU, ER and we also port our own patients to Radiology during weekends because we have no care aids.. This is in the SW area in BC. I also work at a bigger hospital and our care aids stay until 11 pm, we have our own porters but the ratio is still 1 care aid to 20 patients. Our LPNs cannot do full scope practice (x central lines, x iv meds etc).We are also short staffed on a given basis. Workload nurses? 1 on 1 care aid or nurses??? Most of the time not guaranteed and hard to find.

We are managing but the hospitals are also cutting beds here as well... I am thinking of relocating elsewhere in the future so at least I know how it feels like to work in a structured unit that is at least staffed baseline without being short for a week lol

MPKH, BSN, RN · Feb 20, 2016

I work AHS too and our care hub is one RN one LPN and one NA during the day. Teams care for 9-10 patients. The team lead--RN--figures out how to divvy up the charting and meds. I usually divide the load in half with the LPN on my team.

The point? Upper management directive and budget.

joanna73, BSN, RN · Feb 20, 2016

I'm sure you were very busy, but 5 patients is the norm for these units now, and sometimes it's 7 on days.

The very brief period I spent on medicine we had 3 care aides for an 85 bed unit. Read: zero care aides and find your buddy RN to assist with turns and care. Sometimes on days they had 8 acute patients.

Insanity. Never again, I said.

aywl · Feb 21, 2016

Regarding the budget, how can you explain:

the team leader only look after 2 patients, in most situation the patients are not so sick, 3 team leaders in every shift, on top of that, there are a charge nurse to contact Doctor;

dishes, BSN, RN · Feb 21, 2016

Regarding the budget, how can you explain:
the team leader only look after 2 patients, in most situation the patients are not so sick, 3 team leaders in every shift, on top of that, there are a charge nurse to contact Doctor;

I would ask management to explain the logic of three team leaders, a charge nurse, 1 LPN, 1 NA, seems like there are too many queen bees and not enough worker bees.

MPKH, BSN, RN · Feb 21, 2016

The team lead is able to divide the assignment however he or she chooses--if you have issues with it, talk to the team lead or your manager.

On my unit, the charge nurse is part of a care hub. She deals with the charge nurse stuff as well as her own patient load on her team.

We used to have a dedicated charge nurse (no patient assignment) but that's gone now. That's one job cut so it saves money. Also, with the new rotation, my unit will have 3 RNs, 3 LPNs and 3 NAs instead of 4 RNs, 3 LPNs and 2 NAs...cutting down costs.

aywl · Feb 22, 2016

That's exactly what I will do

I would ask management to explain the logic of three team leaders, a charge nurse, 1 LPN, 1 NA, seems like there are too many queen bees and not enough worker bees.

aywl · Feb 22, 2016

Our team leaders always chose the 2 easiest patients for herself and left the heavy patients to others because she has the power to do it, but manager never work at the bedside, she will never know this situation;

The team lead is able to divide the assignment however he or she chooses--if you have issues with it, talk to the team lead or your manager.
On my unit, the charge nurse is part of a care hub. She deals with the charge nurse stuff as well as her own patient load on her team.
We used to have a dedicated charge nurse (no patient assignment) but that's gone now. That's one job cut so it saves money. Also, with the new rotation, my unit will have 3 RNs, 3 LPNs and 3 NAs instead of 4 RNs, 3 LPNs and 2 NAs...cutting down costs.

dishes, BSN, RN · Feb 22, 2016

If sometimes there aren't any acute patients for the team leaders to take, can they take the patients with the most comorbidities? Patients who have higher comorbidities have more to watch for and more potential to become unstable, from a patient safety perspective, it is reasonable that RNs be assigned to them.

Fiona59 · Feb 22, 2016

My unit has been spared this but from what I've heard around the building, this is an issue.

Float pool RNs who are leads, dump the heavies on the regular staff constantly.

Personality conflicts abound.

aywl · Feb 22, 2016

this is a big issue, team leader assigns the easier pts to herself, dump the heavies to others.

...............................

My unit has been spared this but from what I've heard around the building, this is an issue.
Float pool RNs who are leads, dump the heavies on the regular staff constantly.
Personality conflicts abound.